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Individual

DR. D'ETTA MARIA JENKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP, FNP-C

Contact information

Practice address
805 BLARNEY CT, DUBLIN, GA 31021-0793
(478) 290-5757
Mailing address
805 BLARNEY CT, DUBLIN, GA 31021-0793
(478) 290-5757

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN097928
GA
363LF0000X
Family Nurse Practitioner
Primary
F0615110
GA

Other

Enumeration date
06/19/2015
Last updated
06/19/2015
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